Individual
TODD D O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
242 BRUNSWICK ST, OLD TOWN, ME 04468-1613
(207) 827-6128
(207) 827-6605
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 404-8200
(207) 947-0435
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD1016
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030284
ANTHEM
ME
05
—
154750099
—
ME
01
—
201839
NGS
ME
01
—
480034965
MEDICARE PTAN
ME
Enumeration date
03/20/2006
Last updated
05/05/2021
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